title: Brain structural alterations in obsessive-compulsive disorder patients with autogenous and reactive obsessions.
abstract: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. Although structural brain alterations have been consistently reported in OCD, their interaction with particular clinical subtypes deserves further examination. Among other approaches, a two-group classification in patients with autogenous and reactive obsessions has been proposed. The purpose of the present study was to assess, by means of a voxel-based morphometry analysis, the putative brain structural correlates of this classification scheme in OCD patients. Ninety-five OCD patients and 95 healthy controls were recruited. Patients were divided into autogenous (n = 30) and reactive (n = 65) sub-groups. A structural magnetic resonance image was acquired for each participant and pre-processed with SPM8 software to obtain a volume-modulated gray matter map. Whole-brain and voxel-wise comparisons between the study groups were then performed. In comparison to the autogenous group, reactive patients showed larger gray matter volumes in the right Rolandic operculum. When compared to healthy controls, reactive patients showed larger volumes in the putamen (bilaterally), while autogenous patients showed a smaller left anterior temporal lobe. Also in comparison to healthy controls, the right middle temporal gyrus was smaller in both patient subgroups. Our results suggest that autogenous and reactive obsessions depend on partially dissimilar neural substrates. Our findings provide some neurobiological support for this classification scheme and contribute to unraveling the neurobiological basis of clinical heterogeneity in OCD.
authors.affiliation: Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain ; Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Subirà
authors.forename: Pino
authors.initials: P
authors.lastname: Alonso
authors.forename: Cinto
authors.initials: C
authors.lastname: Segalàs
authors.forename: Eva
authors.initials: E
authors.lastname: Real
authors.forename: Clara
authors.initials: C
authors.lastname: López-Solà
authors.forename: Jesús
authors.initials: J
authors.lastname: Pujol
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martínez-Zalacaín
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Harrison
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.forename: Narcís
authors.initials: N
authors.lastname: Cardoner
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009770:Obsessive Behavior / Q000145:classification* / Q000473:pathology; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000473:pathology*